Spine Journal最新文献

{"title":"63. Rutin attenuates distraction spinal cord injury by inhibiting microglial inflammation through downregulation of P38 MAPK/NF-?B/STAT3 pathway","authors":"Weishi Liang MD , Yong Hai MD, PhD","doi":"10.1016/j.spinee.2025.08.245","DOIUrl":"10.1016/j.spinee.2025.08.245","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Distraction spinal cord injury (DSCI) is a severe complication following scoliosis correction surgery, for which there are currently no effective clinical treatments.</div></div><div><h3>PURPOSE</h3><div>This study aims to evaluate the inhibitory effects of rutin, a natural product, on inflammation in DSCI and to investigate the underlying mechanisms.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>This study employed a combination of in vitro and in vivo experimental designs to investigate the anti-inflammatory and neuroprotective effects of rutin in the context of DSCI. The in vitro component utilized a cell culture model to assess the direct effects of rutin on LPS-induced inflammation in microglial cells. The in vivo component involved a randomized controlled animal model of DSCI to evaluate the therapeutic potential of rutin. Molecular studies, including mRNA sequencing, KEGG pathway analysis, and molecular docking, were conducted to elucidate the underlying mechanisms of rutin's action. The study design ensured a comprehensive approach to understanding the role of rutin in mitigating inflammation and promoting recovery following spinal cord injury.</div></div><div><h3>PATIENT SAMPLE</h3><div>N/A</div></div><div><h3>OUTCOME MEASURES</h3><div>N/A</div></div><div><h3>METHODS</h3><div>In Vitro Studies: Microglial cells were cultured in Dulbecco's Modified Eagle Medium (DMEM) supplemented with 10% fetal bovine serum (FBS) and 1% penicillin-streptomycin at 37°C in a humidified atmosphere containing 5% CO2. Cells were seeded in 6-well plates at a density of 1 × 10^6 cells per well and allowed to adhere overnight. To induce inflammation, cells were treated with 1 µg/mL lipopolysaccharide (LPS) for 24 hours. Concurrently, cells were exposed to varying concentrations of rutin (10 µM, 20 µM, and 50 µM) to assess its anti-inflammatory effects. After treatment, cell supernatants were collected, and the levels of inflammatory cytokines (TNF-α, IL-1β, and IL-6) were measured using enzyme-linked immunosorbent assays (ELISA). Cell viability was assessed using the MTT assay to ensure that rutin concentrations used did not induce cytotoxicity. In Vivo Studies: Adult male Sprague-Dawley rats (weight 250-300 g) were used for the dorsal spinal cord injury (DSCI) model. Rats were anesthetized with intraperitoneal injections of ketamine (80 mg/kg) and xylazine (10 mg/kg). A laminectomy was performed at the T10 vertebral level, and the dorsal spinal cord was exposed. DSCI was induced using a weight-drop impactor (10 g weight dropped from a height of 25 mm). Post-surgery, rats were randomly divided into three groups: sham-operated (control), DSCI + vehicle (saline), and DSCI + rutin (50 mg/kg/day, intraperitoneal injection). Behavioral assessments were conducted using the Basso-Beattie-Bresnahan (BBB) locomotor rating scale at 1, 3, 7, 14, and 21 days postinjury. Rats were sacrificed at 21 days postinjury, and spinal cord tissu","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 11","pages":"Pages S33-S34"},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"49. The association between postoperative physical therapy and opioid prescription after posterior lumbar interbody fusion: a retrospective cohort study of United States academic health centers","authors":"Anthony N. Baumann DPT ,&nbsp;Omkar Anaspure BA ,&nbsp;Robert J. Trager DC ,&nbsp;Maria LaMontagne MD ,&nbsp;Keegan Conry MD ,&nbsp;Jacob Charles Hoffmann MD","doi":"10.1016/j.spinee.2025.08.231","DOIUrl":"10.1016/j.spinee.2025.08.231","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Opioid prescription after posterior lumbar fusion has been studied extensively due to high rates of postoperative opioid consumption, especially in view of the ongoing opioid epidemic in the United States. While the use of physical therapy (PT) as a pain management strategy has been associated with reduced opioid use in the treatment of non-surgical lumbar pathologies, there is limited evidence on the association between PT and postoperative opioid prescription after posterior lumbar fusion, potentially influencing spine surgeons’ referral practices.</div></div><div><h3>PURPOSE</h3><div>The aim of this study is to investigate the association between early postoperative PT and the risk and quantity of opioid prescriptions as well as the development of opioid-related disorders after primary posterior lumbar interbody fusion (PLIF) through the first year after surgery.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Retrospective cohort study.</div></div><div><h3>PATIENT SAMPLE</h3><div>There were 4,031 patients in each of the PT and no PT cohorts after matching.</div></div><div><h3>OUTCOME MEASURES</h3><div>Outcomes included the risk ratio (RR) and mean number of opioid prescriptions, as well as the incidence and RR of new opioid-related disorders through one year.</div></div><div><h3>METHODS</h3><div>This study examined United States records in the TriNetX database of opioid-naïve adult patients with a diagnosis of lumbar stenosis who underwent primary PLIF between 2014-2023. Based on the presence or absence of postoperative PT within two months after surgery, patients were placed into either the PT cohort or the no PT cohort. To reduce confounding, propensity matching was done using factors associated with opioid prescription in the literature.</div></div><div><h3>RESULTS</h3><div>As compared to patients in the no PT cohort, patients in the PT cohort had a statistically and clinically significant lower risk of oral opioid prescription [95% CI] (RR: 0.85 [0.83,0.88]; 62.6% versus 73.4%; p&lt;0.0001), a statistically significant lower mean count of oral opioid prescriptions (2.8 versus 3.7; p&lt;0.0001), and a statistically significant lower risk of a new diagnosis of an opioid-related disorder (RR: 0.49 [0.32,0.77]; 0.72% versus 1.5%; p=0.0013) through one year after PLIF.</div></div><div><h3>CONCLUSIONS</h3><div>Early postoperative PT within two months after primary PLIF may be associated with decreased risk of oral opioid prescriptions and new diagnoses of opioid-related disorders in adult through the first year after PLIF, although these results should be taken with caution prior to future corroboration. Surgeons should cautiously consider this data in their referral practices.</div></div><div><h3>FDA Device/Drug Status</h3><div>This abstract does not discuss/include any applicable devices or drugs.</div></div>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 11","pages":"Pages S26-S27"},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"61. Comparison of the postoperative motion stabilization between anterior cervical decompression and fusion with a zero-profile implant system and a plate-cage construct","authors":"Yuan Liu MD ,&nbsp;Sibo Wang PhD ,&nbsp;Haimiti Abudouaini MD ,&nbsp;Prof. Hao Liu","doi":"10.1016/j.spinee.2025.08.243","DOIUrl":"10.1016/j.spinee.2025.08.243","url":null,"abstract":"<div><div>This abstract reflects content previously published in the following source:</div><div>Abudouaini H, Liu H. RF057: Comparison of the postoperative motion stabilization between anterior cervical decompression and fusion with zero-profile implant system and a plate - Cage construct. Global Spine J. 2024 May 10;14(4 Suppl):208S–362S. <span><span>https://pmc.ncbi.nlm.nih.gov/articles/PMC11086046/</span><svg><path></path></svg></span></div></div>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 11","pages":"Page S33"},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2. Social determinants of health associated with lower patient-reported outcomes longer hospitalization in lumbar spine surgery and chronic opioid use","authors":"Aboubacar Wague BA ,&nbsp;Jennifer M O'Donnell MD ,&nbsp;Alex Youn BA ,&nbsp;Nesa Milan MD ,&nbsp;David Gendelberg MD ,&nbsp;Ashraf Nagi El Naga MD ,&nbsp;Sigurd H. Berven MD","doi":"10.1016/j.spinee.2025.08.184","DOIUrl":"10.1016/j.spinee.2025.08.184","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Social determinants of health (SDoH) encompass a range of environmental and personal factors that significantly impact individual health outcomes. Addressing SDoH is particularly important for improving patient care in underserved populations, where these factors have an amplified effect. Patient-reported outcome measures (PROMs) are validated survey tools that provide valuable insights into a patient’s functional status, quality of life, and overall prognosis. Understanding the relationship between SDoH and PROMs is especially relevant in spine surgery, where patient outcomes can vary considerably.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;This study evaluates the predictive influence of SDoH on preoperative and postoperative PROMs at a 2-year follow-up after lumbar spine surgery, as well as their association with length of hospitalization.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;Retrospective cohort study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;Patients who underwent 1- or 2-level lumbar decompression and/or fusion for degenerative lumbar pathology at a single institution.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;Patients completed eight PROMs preoperatively and 2 years postoperatively, including the Oswestry Disability Index (ODI) and PROMIS measures of Anxiety, Depression, Fatigue, Pain Interference (PI), Physical Function (PF), Sleep Disturbance (SD), and Social Roles (SR).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;A retrospective review was conducted on a prospectively maintained patient database at a single institution. Patients who underwent 1- or 2-level lumbar decompression and/or fusion for degenerative lumbar pathology between March 2019 and October 2022 were included. Exclusion criteria were missing SDoH data or a primary cancer diagnosis. Patients completed eight PROMs preoperatively and two years postoperatively, including the ODI and PROMIS measures of anxiety, depression, fatigue, PI, PF, SD, and SR. SDoH variables were independently analyzed using ANOVA, t-tests, and chi-square tests. Univariate and multivariate regression analyses were conducted to identify significant predictors of PROMs and length of hospitalization.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;A total of 440 patients were included, with a mean age of 64.4 years; 44.8% were female. At 2 years postoperatively, ODI, PROMIS Anxiety, PI, PF, and SR improved significantly beyond the minimal clinically important difference. Multivariate analysis identified 5 SDoH factors as significant predictors of worse preoperative PROMs: chronic opioid use (8/8 PROMs), disability (8/8 PROMs), unemployment (6/8 PROMs), retirement (5/8 PROMs), and metabolic equivalents of task (METs) (4/8 PROMs). At 2 years postoperatively, all of these variables, except retirement, remained significant predictors of worse patient-reported outcomes across all survey domains. Additionally, age, METs, Black race, and chronic opioid use were significant predict","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 11","pages":"Pages S2-S3"},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"10. Bridging health literacy gaps in spine care: using ChatGPT-4 to improve patient education materials","authors":"Joseph Nassar BS ,&nbsp;Michael Farias BS ,&nbsp;Lama Ammar MSc ,&nbsp;Rhea Rasquinha BS ,&nbsp;Andrew Xu BA ,&nbsp;Manjot Singh BS ,&nbsp;Mohammad Daher BS ,&nbsp;Krish Shah BS ,&nbsp;Marco Kaper BA ,&nbsp;Michelle Jun BS ,&nbsp;Daniel Alsoof MBBS ,&nbsp;Bassel G. Diebo MD ,&nbsp;Alan H Daniels MD","doi":"10.1016/j.spinee.2025.08.192","DOIUrl":"10.1016/j.spinee.2025.08.192","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Patient education materials (PEMs) are essential for improving health literacy, patient engagement, and treatment adherence. However, many exceed recommended readability levels, disadvantaging individuals with limited health literacy.</div></div><div><h3>PURPOSE</h3><div>To evaluate the readability of spine-related PEMs from the American Academy of Orthopaedic Surgeons (AAOS), North American Spine Society (NASS), and American Association of Neurological Surgeons (AANS) and examine the potential of artificial intelligence (AI) to optimize PEMs for better comprehension.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Readability analysis of spine-related PEMs with AI-based optimization.</div></div><div><h3>PATIENT SAMPLE</h3><div>A total of 146 spine-related PEMs from the AAOS, NASS, and AANS websites.</div></div><div><h3>OUTCOME MEASURES</h3><div>Readability scores including Flesch-Kincaid Grade Level (FKGL) and Simple Measure of Gobbledygook (SMOG) Index, linguistic complexity, passive voice use, and content accuracy.</div></div><div><h3>METHODS</h3><div>A total of 146 spine-related PEMs from AAOS, NASS, and AANS websites were analyzed. Readability was assessed using the FKGL and SMOG Index scores, along with other linguistic metrics such as language complexity and passive voice use. ChatGPT-4.0 was utilized to revise PEMs to a 6th-grade reading level, and post-revision readability was reassessed. Test-retest reliability was evaluated, and paired t-tests compared the readability scores of original and AI-modified PEMs.</div></div><div><h3>RESULTS</h3><div>Original PEMs had a mean FKGL of 10.2±2.6, significantly exceeding both the recommended 6th-grade reading level and the US average 8thgrade reading level (p&lt;0.05). AI-generated revisions significantly improved readability, reducing the mean FKGL to 6.6±1.3 (p&lt;0.05). ChatGPT-4.0 also enhanced other readability metrics, including SMOG Index, language complexity, and passive voice use, while preserving accuracy and adequate detail. Excellent test-retest reliability was observed across all metrics (ICC range: 0.91–0.98).</div></div><div><h3>CONCLUSIONS</h3><div>Spine-related PEMs from AAOS, NASS, and AANS remain overly complex despite minor improvements over time. ChatGPT-4.0 demonstrates strong potential to enhance PEM accessibility while maintaining content integrity. Future efforts should integrate AI tools with visual aids and user-friendly platforms to create inclusive and comprehensible PEMs, addressing diverse patient needs and improving healthcare delivery.</div></div><div><h3>FDA Device/Drug Status</h3><div>This abstract does not discuss or include any applicable devices or drugs.</div></div>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 11","pages":"Page S7"},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"56. Comparative study: platelet rich fibrin (PRF) vs radiofrequency medial ranch neurotomy (RF-MBN) for lumbar facet joint syndrome","authors":"Yung Chen MD","doi":"10.1016/j.spinee.2025.08.238","DOIUrl":"10.1016/j.spinee.2025.08.238","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Lumbar facet joint syndrome is a prevalent cause of chronic lower back pain. Radiofrequency medial branch neurotomy (RF-MBN) alleviates pain by ablating the medial branch nerves but requires repeat procedures and may contribute to paraspinal muscle degeneration and spinal instability. Platelet-Rich Fibrin (PRF), an autologous regenerative therapy, promotes tissue healing without neural damage by releasing bioactive molecules that enhance cellular repair and neuroprotection. Unlike RF-MBN, PRF provides sustained pain relief, does not require sedation, and has no reported adverse effects.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;To compare the efficacy, duration of pain relief, and safety of PRF injections versus RF-MBN in the management of chronic lumbar facet joint syndrome.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;A retrospective cohort analysis was conducted on 160 patients diagnosed with chronic lumbar facet joint syndrome over a 10-year period. Patient records were reviewed to evaluate the outcomes of these standard clinical treatments, all performed under fluoroscopic guidance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;A total of 160 patients with confirmed lumbar facet joint syndrome were included based on clinical examination, imaging studies, and positive response to medial branch nerve blocks.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;Primary outcome: Pain reduction at 12 months (VAS). Secondary outcomes: Functional improvement (ODI), adverse event rates, need for repeat procedures, and postprocedural complications. Safety outcomes included sedation-related side effects and paraspinal muscle degeneration.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;Patients were retrospectively categorized into two treatment groups: PRF Injection: Intra-articular PRF injection performed under fluoroscopic guidance every six months without sedation. RF-MBN: Medial branch nerve ablation performed under fluoroscopic guidance with sensory/motor threshold monitoring, requiring sedation, and repeated every six months.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Pain Relief: At 12 months, 82% of PRF patients reported &gt;80% pain reduction compared to 60% in the RF-MBN group (p &lt; 0.01, 95% CI: 75%-89%). Relief Duration: PRF provided sustained relief in 78% of patients beyond 12 months, while RF-MBN required repeat procedures after 10.2 months (p &lt; 0.05, 95% CI: 72%-84%). Functional Improvement: ODI scores improved in 85% of PRF patients vs 65% in RF-MBN patients (p &lt; 0.01, 95% CI: 78%-92%). Safety: PRF had no reported adverse events, whereas RF-MBN had a 7% complication rate, primarily transient pain flares and minor motor deficits. Sedation: PRF required no sedation, while 38% of RF-MBN patients experienced sedation-related side effects, prolonging recovery. Muscle Stability: No paraspinal muscle degeneration was observed in PRF patients, whereas RF-MBN patients demonstrated an increased risk of spinal instability due","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 11","pages":"Pages S30-S31"},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"12. Predictors of immediate postoperative neurologic changes in intermedullary spinal cord tumor patients","authors":"Riya M Dange BS ,&nbsp;Amelia Stepniak MS ,&nbsp;Neslihan Nisa Gecici MD ,&nbsp;Parthasarathy Thirumala MD","doi":"10.1016/j.spinee.2025.08.194","DOIUrl":"10.1016/j.spinee.2025.08.194","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Intramedullary spinal cord tumors (IMSCTs) are rare central nervous system neoplasms that grow beneath the meninges and may invade the spinal cord parenchyma. Disease progression is associated with high neurologic impairment risks, which must be weighed against the morbidity risks of treatment by gross total resection (GTR), the current standard of care. Given the rarity of these tumors, data on immediate postresection neurologic changes are limited in scope and generalizability.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;We evaluated the predictive value of several perioperative factors on immediate postoperative neurologic outcomes in patients with IMSCTs. Identifying significant predictors of neurologic deficits and improvements can refine pre-surgical risk estimation for treatment determination and patient counseling in a shared decision-making model. Furthermore, a bolstered understanding of predictor-outcome associations can help optimize the standard of care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;For this single-center retrospective cohort study, we collated a database comprising all patients who received surgical resection for IMSCTs at a University of Pittsburgh Medical Center hospital between December 2002 and January 2020.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;Of the 138 patients in the database, 90 met inclusion criteria for this study based on the availability of complete immediate pre- and postoperative neurologic exam information. Of these, 70 (78%) received near gross total resections (nGTRs, ≥90% of tumor mass on visual inspection of postoperative MRIs), while 20 (22%) received subtotal resections (STRs). The patients spanned 5 tumor pathology categories: astrocytomas (n=3, 3%), ependymomas (n=33, 37%), myxopapillary ependymomas (n=24, 27%), hemangioblastomas (n=18, 20%), and low-grade gliomas (n=12, 13%).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;The primary outcome was immediate postoperative neurologic changes, measured as differences between preoperative and immediate postoperative exams. Findings were categorized as “no difference,” “deficits” (negative changes from pre- to post-operative), or “improvements” (positive changes from pre- to postoperative).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;Fisher’s exact tests were conducted in R to explore associations between the primary outcome and 6 variables of interest: extent of resection (EoR), tumor pathology, tumor location, tumor recurrence, prior surgery, and critical changes on intraoperative somatosensory evoked potentials. Level-specific associations were assessed by post-hoc pairwise comparisons with Bonferroni corrections. Significance was defined as p &lt; 0.05.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Immediate postoperative neurologic changes varied significantly by EoR (p = 0.004) and tumor pathology (p = 0.003). Per post-hoc comparisons, nGTRs were significantly associated with a higher proportion of postoperative defici","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 11","pages":"Pages S7-S8"},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"69. Is successful closed skeletal traction prior to surgery for patients with traumatic locked facet of subaxial cervical spine associated with superior neurologic improvement?","authors":"Ahmad Ozair MD, MPH","doi":"10.1016/j.spinee.2025.08.251","DOIUrl":"10.1016/j.spinee.2025.08.251","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Traumatic locked facet in the subaxial cervical spine can be treated with closed skeletal traction (CST) prior to definitive surgery. Comparison of neurologic outcomes among patients with successful CST versus unsuccessful or no attempted CST prior to surgery are lacking.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;We aimed to determine whether successful CST prior to definitive surgery for patients with traumatic locked facet of subaxial cervical spine is associated with superior neurologic improvement.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;This was a single-center retrospective study of patients treated at an apex Level I trauma center in the United States.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;Consecutive patients with traumatic locked facet in the subaxial cervical spine presenting to the trauma center during during 2008-2022 were included. Patients with less than 90-day follow-up and those with cervical spine injuries other than de facto locked facet (unilateral or bilateral) were excluded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;The primary study outcome was improvement in ASIA motor score (AMS), assessed after 3 months.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;Socio-demographic, clinical, and procedural variables were extracted and analyzed using descriptive and inferential statistics, including multivariable regression analyses, in StataBE 17. Univariate associations and clinical expertise were jointly utilized for multivariable model selection, with Akaike information criterion (AIC) used to assess model fit. Violin, deviation, waterfall, and coefficient plots were used for visualization.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;A total of 67 patients were included, with a median age of 51 years (interquartile range [IQR]) 31-64). 21 (31%) patients were female, and locked facet was bilateral in 39% (N=26). Mechanism was high-energy trauma (motor vehicle collision or fall from height) in 67% (N=42). Modified 5-factor frailty index (MFI-5) score was 0 in 69%, 1 in 21%, and 2 or greater in 10%. At admission, ASIA impairment scale (AIS) grades were A, B, C, and D in 36%, 13%, 9%, and 42%, respectively, and median ASIA motor score was 38 (IQR 15-94). CST was attempted in 55 patients (82%), being successful in 60% of those (n=33) patients. Intramedullary lesion length (IMLL) was 29.05 mm (IQR 11.4-42.6) at admission and 39 (IQR 18.15-60.05) postoperatively. IMLL and ASIA score were found collinear. At 3-month follow-up, AIS grades were A, B, C, D, and E in 16.4%, 17.9%, 6%, 43.3%, and 16.4%, respectively and median AMS was 94 (IQR 30-100). Median improvement in AMS was 11 (IQR 3-33). Based on previously reported minimum clinically important difference (MCID) improvement in AMS of ³6, 69% (n=46) had improved by 3-months. In a multivariable logistic regression for MCID ASIA change, with covariates of admission IMLL, MFI-5, successful CST, and age categories, only admission IMLL had a significant asso","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 11","pages":"Page S37"},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"39. Effect of semaglutide on 90-day and 2-year surgical and medical complications in diabetic patients undergoing anterior cervical discectomy and fusion","authors":"Uttsav Patel BA ,&nbsp;Rafael Madera BS ,&nbsp;Joseph Kim BS ,&nbsp;Sean Jang BS ,&nbsp;Brian Lynch MD","doi":"10.1016/j.spinee.2025.08.221","DOIUrl":"10.1016/j.spinee.2025.08.221","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Semaglutide, a glucagon-like peptide-1 receptor agonist, has shown efficacy in improving glycemic control and promoting weight reduction in diabetic patients. However, its impact on postoperative outcomes, particularly in the context of spinal surgeries, remains uncertain. While studies on lumbar fusion procedures have yielded mixed results, some suggest that semaglutide may influence bone turnover and muscle mass, which could affect the healing process following spinal fusion. One study indicated an increased risk of requiring additional surgeries post-transforaminal lumbar interbody fusion (TLIF). In contrast, others noted reduced complications following single-level posterior lumbar fusion, including fewer emergency department visits and adverse events. These inconsistencies point to the need for further research to clarify the effects of semaglutide on surgical outcomes in spinal fusion procedures, specifically in the context of anterior cervical discectomy and fusion (ACDF).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;The purpose of this study is to evaluate the impact of semaglutide on 90-day and 2-year surgical and medical complications in diabetic patients undergoing ACDF.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;A retrospective cohort study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;A retrospective cohort study was conducted utilizing the TriNetX research network, a comprehensive healthcare database. Diabetic patients undergoing ACDF were divided into two groups based on their use of semaglutide: Cohort 1 (patients prescribed semaglutide at the time of surgery) and Cohort 2 (patients with no history of semaglutide use). Propensity score matching was applied to balance the two groups' baseline demographic and clinical characteristics. Surgical and medical outcomes, including both early (90-day) and long-term (2-year) complications, were compared between the two cohorts. The primary outcomes assessed were major medical and surgical complications, and the risk ratios (RR) were calculated for each complication at both 90-day and 2-year intervals.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;At the 90-day postoperative mark, no significant differences were found between the two groups for any of the complications analyzed. However, at the 2-year follow-up, semaglutide use was associated with a significant reduction in three major complications: mortality, pseudarthrosis, and general postoperative mechanical complications. Specifically, semaglutide use was linked to lower odds of mortality (2.6% vs 5.2%, RR = 0.487, 95% CI = 0.253 - 0.935, P = 0.028), a decrease in pseudarthrosis rates (6.7% vs 12.9%, RR = 0.487, 95% CI = 0.319 - 0.743, P = 0.001), and a reduction in general post-operative mechanical complications (11.4% vs 17.8%, RR = 0.596, 95% CI = 0.421 - 0.843, P = 0.003).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSIONS&lt;/h3&gt;&lt;div&gt;The","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 11","pages":"Page S21"},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"84. Insertional torque and pull-out strength for reinserted porous threaded implants for sacroiliac joint fusion","authors":"Cale Hendricks BS ,&nbsp;Ashley Abbott BS ,&nbsp;Yaqoub Yusuf MS ,&nbsp;Matthew MacEwen PhD ,&nbsp;Rafael Garcia BS ,&nbsp;David W. Polly MD ,&nbsp;Arin M. Ellingson PhD","doi":"10.1016/j.spinee.2025.08.267","DOIUrl":"10.1016/j.spinee.2025.08.267","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Sacroiliac joint (SIJ) fusion is a common procedure for SIJ dysfunction and pain. Historically, standard threaded screws were used; however, a novel 3D-printed porous threaded implant (PTI) has emerged to induce osseointegration. Limited literature exists on insertional and pullout characteristics, especially for revision.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;Therefore, this study investigated the re-insertional torque and pullout strength across various PTI dimensions and conditions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;Biomechanical.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;Mechanical testing (ASTM F543) was conducted to evaluate insertional torque and pull-out strength. Using 10 and 20pcf (lbs/ft3) polyurethane blocks, the TORQ iFuse Implant (SI-Bone, Santa Clara, CA) was tested. A 10 × 35mm PTI served as the control. For subsequent tests, the 10 × 35mm PTI was removed, and varying diameters (10, 11.5, 12.5mm) and lengths (35, 40, 45mm) were reinserted. The maximum and final insertional torque and the maximum axial pullout load were measured. Reinsertion followed two conditions: direct and with tapping. ANOVA techniques with pairwise comparison and Pearson correlation tests between insertional torque and pullout force were performed (α=0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Significant effects and interactions were observed for PTI size, bone density, and tapping. Independent of density and tapping, maximum insertional torque was significantly less than the control for the similar size PTI (10 × 35, 10 × 40; p&lt; 0.001) and significantly greater for large PTIs (11.5 × 40, 11.5 × 45, 12.5 × 35, 12.5 × 40, 12.5 × 45; p&lt; 0.012). Pullout force was significantly less than the control for short PTIs (10 × 35,11.5 × 35,12.5 × 35; p&lt; 0.028) and significantly greater for long PTIs (11.5 × 45; p&lt; 0.001). Independent of size and tapping, the denser bone was significantly greater for maximum insertional torque (20 vs 10pcf | 929.1±6.5N vs 235.0±6.5N·cm; p&lt; 0.001) and pullout force (20 vs 10pcf | 1331.2±14.8 vs 457.3±14.6N; p&lt; 0.001). Independent of size, tapping showed a significant increase for maximum insertional torque (‘tap’ vs ‘no tap’ | 1063.6±9.2 vs 794.5±9.2N-cm; p&lt; 0.001) and pullout force (1799.1±20.9 vs 863.4±20.9N, p&lt; 0.001) with the denser bone; however, a significant decrease was shown for pullout force (399.7±20.6 vs 514.9±20.6N; p&lt; 0.001) with the less dense bone. Final insertional torque trends matched those for maximum insertion torque except for 20pcf foam without tapping, which was substantially less with increased diameters. Pullout force was shown to be correlated to maximum (r=.829; p&lt;.001) and final (r=.946; p&lt;.001) insertional torque across all conditions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSIONS&lt;/h3&gt;&lt;div&gt;Increased PTI lengths equated to greater engagement, but e","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 11","pages":"Page S45"},"PeriodicalIF":4.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}